scholarly journals Stiff-Person Syndrome Outpatient Rehabilitation: Case Report

2020 ◽  
Vol 11 (04) ◽  
pp. 651-653
Author(s):  
Fayaz Khan ◽  
Mohamed Faisal Chevidikunnan ◽  
Raghad Ahmad Almalki ◽  
Mawada Khaled Mirdad ◽  
Khadeeja Abdulaziz Nimatallah ◽  
...  
Keyword(s):  
Muscle Power ◽  
Outpatient Rehabilitation ◽  
Muscle Rigidity ◽  
Functional Abilities ◽  
Stiff Person Syndrome ◽  
Baseline Measurement ◽  
Program Outcome ◽  
Therapeutic Exercises ◽  
General Improvement ◽  
Movement Difficulties

AbstractStiff-person syndrome (SPS) is a rare neurological disorder that causes muscle rigidity and stiffness of the trunk and proximal limb muscles, leading to movement difficulties and impaired function. Due to the rarity of the disease, studies on the benefit of rehabilitation for this disorder are quite limited. A 46-year-old female patient diagnosed with SPS complained of imbalance and movement difficulty. We prescribed therapeutic exercises aimed to reduce the stiffness of the trunk and proximal limbs and improve her function. Baseline measurement of the patient's range of motion, muscle power and tone, balance and functional abilities were taken pre- and post-program. Outcome measures showed a general improvement in the patient's muscle flexibility, balance, and functionality.

Anti-amphiphysin positive stiff-person syndrome due to invasive ductal carcinoma in a male patient

2021 ◽  
Vol 14 (5) ◽  
pp. e237738
Author(s):  
Christopher Connolly ◽  
Erin Cobain ◽  
Tasha Hughes
Keyword(s):  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Diagnostic Testing ◽  
Muscle Rigidity ◽  
Stiff Person Syndrome ◽  
Curative Intent ◽  
Lung Cancers ◽  
Oncological Treatment ◽  
Positron Emission ◽  
Magnetic Resonance Imaging Mri

Stiff-person syndrome (SPS) is a rare progressive neurological disorder characterised by painful muscle spasms and progressive muscle rigidity, leading in some cases to impaired ambulation. Anti-amphiphysin positive SPS is a paraneoplastic variant, frequently associated with breast carcinomas and small cell lung cancers. We report the case of a 53-year-old patient who developed symptoms of anti-amphiphysin positive SPS 3 years before being diagnosed with invasive ductal carcinoma. Specifically, computed tomography (CT) of the chest, abdomen and pelvis, positron emission tomography-CT (PET-CT), mammogram, colonoscopy and magnetic resonance imaging (MRI) did not identify malignancy during the 3 years following the onset of symptoms. Following diagnosis of invasive ductal carcinoma and completion of curative-intent oncological treatment, the patient experienced improvement, though not complete resolution, in his SPS symptoms. This case highlights the importance of thorough oncological workup when clinical presentation and diagnostic testing are suggestive of anti-amphiphysin positive SPS.

scholarly journals Paraneoplastic Stiff Person Syndrome in Early-Stage Breast Cancer with Positive Anti-Amphiphysin Antibodies

2020 ◽  
Vol 12 (3) ◽  
pp. 339-347
Author(s):  
Vitalie Vacaras ◽  
Enia Eleonora Cucu ◽  
Roxana Radu ◽  
Dafin Fior Muresanu
Keyword(s):  
Breast Cancer ◽  
Breast Tumor ◽  
Early Stage ◽  
Acid Decarboxylase ◽  
Muscle Rigidity ◽  
Stiff Person Syndrome ◽  
Gad Antibodies ◽  
Neurologic Disorder ◽  
Muscle Cramps ◽  
Classic Form

Stiff person syndrome (SPS) is a rare neurologic disorder, characterized by muscle rigidity and spasms. Anti-glutamic acid decarboxylase (anti-GAD) antibodies are associated with the classic form of SPS, while antibodies against amphiphysin are associated with the paraneoplastic form of the disease. We present the case of a patient with paraneoplastic SPS, presenting with muscle cramps of lower extremities that progressed to severe muscle rigidity and spasms, associated with a right breast tumor and positive anti-amphiphysin antibodies. Paraneoplastic SPS is a rare neurological disorder, challenging for the physicians both to diagnose and treat.

scholarly journals Difficult to Treat Focal, Stiff Person Syndrome of the Left Upper Extremity

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Nathan E. Esplin ◽  
John W. Stelzer ◽  
Timothy B. Legare ◽  
Sayed K. Ali
Keyword(s):  
Upper Extremity ◽  
Muscle Tone ◽  
Good Control ◽  
Symptomatic Treatment ◽  
Muscle Rigidity ◽  
Stiff Person Syndrome ◽  
Mild Improvement ◽  
History Of ◽  
Gad 65 ◽  
Axial Musculature

Background. Stiff person syndrome (SPS) is a rare neurologic disorder characterized by muscle rigidity. It is a disorder of reduced GABA activity leading to increased muscle tone and often painful spasms. It generally presents in the axial musculature but rarely can involve only one limb, typically a lower extremity. In rare cases it can be paraneoplastic which generally resolves on treatment of the underlying neoplasm. Case Report. A 46-year-old male with a history of Hodgkin’s Lymphoma in remission presented with left upper extremity pain secondary to a diagnosis of Stiff Person Syndrome limited to his left upper extremity. He had previously benefitted from plasmapheresis and was on diazepam and baclofen at home with relatively good control of his symptoms. SPS had previously been diagnosed with EMG and anti-GAD-65 antibody titers and was confirmed by an elevated anti-GAD-65 antibody titer. He was treated with plasmapheresis and maximum doses of medical treatment including botulinum toxin with only transient mild improvement in his symptoms. Conclusion. This case represents a case of a rare disease that was refractory to all known therapies. It outlines the need for further understanding of this disorder in order to provide better symptomatic treatment or potentially more definitive care.

A randomized, single-blinded pilot study evaluating the effects of kinesiology taping and the tape application techniques in addition to therapeutic exercises in the treatment of congenital muscular torticollis

2016 ◽  
Vol 31 (8) ◽  
pp. 1098-1106 ◽  
Author(s):  
Esra Giray ◽  
Evrim Karadag-Saygi ◽  
Basak Mansiz-Kaplan ◽  
Duygu Tokgoz ◽  
Ozun Bayindir ◽  
...  
Keyword(s):  
Post Treatment ◽  
Outpatient Rehabilitation ◽  
Neck Muscle ◽  
Congenital Muscular Torticollis ◽  
Affected Side ◽  
Therapeutic Exercises ◽  
Application Techniques ◽  
Group 3 ◽  
Muscular Torticollis ◽  
Inhibition Technique

Objective: To investigate the effects of kinesiology taping and different types of application techniques of kinesiology taping in addition to therapeutic exercises in the treatment of congenital muscular torticollis. Design: Prospective, single blind, randomized controlled trial. Setting: An outpatient rehabilitation clinic in a tertiary university hospital. Subjects: Infants with congenital muscular torticollis aged 3-12 months. Interventions: Group 1 included 11 infants who only received exercises, Group 2 included 12 infants who received kinesiology taping applied on the affected side by using inhibition technique in addition to exercises. Group 3 included 10 infants who additionally received kinesiology taping applied on the unaffected side by using facilitation technique and on the affected side by using inhibition technique. Main measures: Range of motion in lateral flexion and rotation of the neck, muscle function and degree of craniofacial changes were assessed at pretreatment, post treatment and, 1 month and 3 months’ post treatment. Results: Friedman analysis of within-group changes over time revealed significant differences for all of the outcome variables in all groups except cervical rotation in Group 3 ( P<0.05). No significant differences were found between groups at any of the follow-up time points for any of the outcome variables ( P>0.05). Conclusions: There is no any additive effect of kinesiology taping to exercises for the treatment of congenital muscular torticollis. Also different techniques of applying kinesiology taping resulted in similar clinical outcomes.

scholarly journals The impact of a COVID-19 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report

2020 ◽  
Author(s):  
Tobias Braun ◽  
Raphael Weidmann ◽  
Jens Carsten Möller ◽  
Anissa Ammann ◽  
Detlef Marks
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Case Report ◽  
Physical Functioning ◽  
Neurological Disorders ◽  
Neurological Diseases ◽  
Inpatient Rehabilitation ◽  
Outpatient Rehabilitation ◽  
Rehabilitation Service ◽  
Functional Abilities

Abstract Background: Regular outpatient rehabilitation is prescribed for many patients with chronic neurological disorders, such as Parkinson's disease or Multiple Sclerosis, to constantly support patients and their proxies in disease management. Due to the COVID-19 pandemic, federal institutions and governments worldwide have directed local or nationwide lockdowns. During these times, the provision of regular outpatient rehabilitation service is drastically limited, making it actually impossible for community-dwelling patients with neurological disorders to receive prescribed rehabilitation interventions.Case presentation: A 67-year-old man with two chronic neurological diseases, Parkinson's disease and Multiple Sclerosis, underwent a 4-week inpatient rehabilitation in our hospital. The patient gained significant functional improvements that he maintained over the following months, supported by the continuation of physiotherapy in the domestic environment. Due to a COVID-19 pandemic related interruption of the regular ambulatory rehabilitation for several weeks, the patient’s functional abilities decreased significantly. Thus, the patient was again referred to our hospital for intensive inpatient rehabilitation to regain his physical functioning and mobility capacity. At hospital discharge, the patient improved most of his physical functioning to a pre-pandemic level.Conclusions: The interruption of a rehabilitation service due to a pandemic-related lockdown can significantly impact the functional abilities of patients with chronic neurological diseases. This case report supports the claim for continuous access to rehabilitation services for all people with rehabilitation needs.

scholarly journals Remote Rehabilitation of Patients with Impaired Motor Functions in Cerebral Pathology

2021 ◽  
Vol 20 (1) ◽  
pp. 45-50
Author(s):  
Irina P. Yastrebtseva ◽  
Vadim D. Daminov ◽  
Lydia Yu. Deryabkina ◽  
Svetlana V. Vyalkova ◽  
Ksenia V. Makshantsevа
Keyword(s):  
Comparison Group ◽  
Berg Balance Scale ◽  
Outpatient Rehabilitation ◽  
Cerebral Stroke ◽  
Life Questionnaire ◽  
Motor Functions ◽  
Mobility Index ◽  
Balance Scale ◽  
Therapeutic Exercises ◽  
Significant Difference

Introduction. After passing the inpatient rehabilitation program, patients often experience a regression of the results achieved due to the low activity of outpatient rehabilitation. The solution to this problem is the introduction of remote rehabilitation programs. Purpose. To analyze the results of remote patients’ rehabilitation with impaired motor functions in cerebral stroke using Steps Reabil software. Material and methods. 32 patients with stroke were examined at the ISMA clinic. They were randomly assigned to a group of patients who continued a remote course of kinesotherapy using the Steps Reabil program for 3 months. (Steps Reabil group, n = 14) and to the group of people who received recommendations on therapeutic exercises for homework and were not appealing to this software (comparison group, n = 18). At the time of discharge, 1 and 3 months into, the capabilities were evaluated according to the Frenchay, «Stand up and go» tests, the Rivermead mobility index and Hauser Ambulation Index, the Berg Balance Scale, and the EuroQol-5D quality of life questionnaire. Results. When comparing the initial results in the study groups, a statistically significant difference was found between the indicators on the Berg Balance Scale (the indicators were lower in the Steps Rehabil group), but the differences were leveled out after 3 months. When comparing the results in the Steps Reabil group at discharge and after 3 months, there was an improvement as of the Berg Balance Scale, the Rivermead mobility index and the Hauser Ambulation Index, and the Frenchay arm test. In the comparison group, from the moment of discharge and 3 months into, the results on the Berg Balance Scale improved (p <0.05). Conclusion. The functioning of patients who continued rehabilitation kinesiotherapeutic measures using modern information technologies continues to improve effectively in everyday life. Remote rehabilitation for 3 months is much more effective than short-term monthly, which indicates the need for continuous controlled rehabilitation measures. The Berg Balance Scale is especially sensitive in assessing the functional capabilities of patients.

scholarly journals The application of high intensity and low intensity magnetotherapy in rehabilitation of patients with COVID-19 - a randomized controlled pilot study.

2020 ◽  
pp. 322-328
Author(s):  
Eiena Silantyeva
Keyword(s):  
Electromagnetic Field ◽  
High Intensity ◽  
Severe Pneumonia ◽  
Clinical Effectiveness ◽  
Rehabilitation Medicine ◽  
Outpatient Rehabilitation ◽  
Control Group ◽  
Low Intensity ◽  
Therapeutic Exercises ◽  
Rehabilitation Measures

Background: rehabilitation of patients after severe pneumonia associated with the new coronavirus infection requires the searching for effective tools to restore impaired functions, including methods of hardware physiotherapy. Aims: to evaluate the effectiveness of the application of high-intensity electromagnetic field (HIEF) in rehabilitation of patients after pneumonia associated with COVID-19. Materials and methods: 40 patients were examined and treated at the outpatient stage of rehabilitation after severe pneumonia associated with COVID-19. All patients received a set of rehabilitation measures, including daily sessions of therapeutic exercises (No. 15) and magnetotherapy procedures (No. 15). Patients were randomly separated into 2 groups - 20 patients in the treatment group (TG) who received HIEF therapy (BTL-6000 Super Inductive System) and 20 patients in the control group (CG) who received low-intensity magnetotherapy (BTL-4000 Premium device). Results: during the course of therapy, there were no patients who dropped out of the study, and no undesirable side effects and complications were identified. The high clinical effectiveness of the complex of rehabilitation measures has been proven, more pronounced in the group of patients receiving HIEF therapy. The results were confirmed by reliable dynamics of clinical indicators according to the valid questionnaire and positive changes in spirometry data. Conclusions: application of high-intensity electromagnetic field (HIEF) is advisable in complex outpatient rehabilitation of patients after severe pneumonia associated with COVID-19 . Keywords: COVID-19, pneumonia, magnetotherapy, high-intensity electromagnetic field, physical and rehabilitation medicine.

scholarly journals Stiff-Person Syndrome: Seeing Past Comorbidities to Reach the Correct Diagnosis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Jared Hicken ◽  
Daniel Ramirez ◽  
Mark Rigby ◽  
Aram Minasian
Keyword(s):  
Correct Diagnosis ◽  
Acid Decarboxylase ◽  
Muscle Rigidity ◽  
African American Female ◽  
Stiff Person Syndrome ◽  
Gamma Aminobutyric Acid ◽  
Axial Muscle ◽  
History Of ◽  
The Central Nervous System ◽  
Psychotic Features

Stiff-person syndrome (SPS) is a rare disorder seen in approximately one in one million people. Although it is rare, the symptoms and findings of a typical case should paint a clear clinical picture for those who are familiar with the disease. The primary findings in SPS include progressive axial muscle rigidity as well as muscle spasms. These symptoms most commonly occur in the setting of antibodies against Glutamic Acid Decarboxylase (GAD), the rate-limiting enzyme in the production of Gamma-Aminobutyric Acid (GABA), which is the primary inhibitory enzyme in the central nervous system. Here, we report the case of a 65-year-old African-American female with a past medical history of hypothyroidism, anxiety, and depression with psychotic features who presented with axial muscle rigidity and lactic acidosis. She had been symptomatic for several months and reported extensive workups performed at two previous hospitals without a definitive diagnosis. A complete neurological and musculoskeletal investigation yielded no positive findings except for the presence of GAD antibodies. The patient was treated with diazepam, tizanidine, and Intravenous Immunoglobulin (IVIG) with significant improvement, thus solidifying the diagnosis of SPS, a rare autoimmune and/or paraneoplastic syndrome.

Training for Muscle Power in Older Adults: Effects on Functional Abilities

2003 ◽  
Vol 28 (2) ◽  
pp. 178-189 ◽  
Author(s):  
Kim V. Hruda ◽  
Audrey L. Hicks ◽  
Neil Mccartney
Keyword(s):  
Older Adults ◽  
Exercise Training ◽  
Muscle Power ◽  
Functional Performance ◽  
Average Power ◽  
Functional Abilities ◽  
Lower Body ◽  
Term Care ◽  
Chair Stand ◽  
Timed Test

The purpose of this study was to determine the influence of simple, progressive lower body exercise training, focusing on strength and power, on functional abilities in frail older adults. Twenty-five residents of a long-term care facility (75-94 yrs) participated in this randomized controlled trial of 10 wks duration. The exercise group (Ex, n = 18) underwent simple, progressive lower body resistance exercises, specifically aimed at improving muscle power, 3 times/wk; the control subjects (Con, n = 7) maintained their usual daily activities. Knee extensor strength and power were measured on an isokinetic dynamometer (180°/s), and functional performance was assessed from a 6 m walk timed test, a 30 s chair stand, and an 8 ft up-and-go timed test, before and after the 10 wk intervention period. Significant increases were found in the Ex group for eccentric (44%) and concentric (60%) average power (p < 0.05), and improvements were seen on each functional test: the 8-foot up-and-go, chair stand, and walk time improved by 31%, 66%, and 33%, respectively (p < 0.05). No significant change occurred in the Con group. In conclusion, simple progressive exercise training, even in the 10th decade, increases muscle power and is associated with an improved performance of functional activities using the trained muscles. Key words: frail elderly, leg strength, functional performance

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